The diagnosis of a patient's condition often relies on the use of medical images. Medical images (e.g., X-ray, CT, MRI, and ultrasound images) are intended to provide a detailed view of a patient's anatomy. Once captured, a trained health care worker—such as a trained cardiologist or radiologist—reviews the one or more medical images taken of a patient and prepares a report of what the images appear to show in order to diagnose possible pathologies, determine possible approaches to treatment, and guide and evaluate the results of treatment.
There are a variety of known approaches by which reports based on the review of medical images can be created. One conventional approach—that may use dictation and voice recognition—can produce free-text narrative reports with little or no coded data. Another conventional approach—in which a physician records coded data elements and from which the reporting system generates report narrative—is termed structured reporting.
Many of the known clinical reporting systems permit a drawing to be prepared and included as part of the report. In certain known clinical reporting systems, the drawing can be very basic and can consist of a simple line drawing depicting anatomical features that may be commonly found in a hypothetical model patient. A health care worker uses the simple anatomical cartoon typically to record the worker's observations, thoughts, and conclusions while reviewing the separate medical images taken of a patient's actual anatomy. Onto the simple drawing, the worker can apply text annotations to explain what is seen in the separate medical patient images. Some known reporting systems allow a worker to make free-form modifications via basic drawing operations (e.g., draw line, fill region, erase line/region onto a simple lined drawing).
The disadvantage of such reporting systems is that the worker must work back and forth with at least two images—the medical image or images taken of the patient and the simple drawing—in order to produce the annotated/modified simple drawing. This process is inherently inefficient and can create errors. Another disadvantage is that, while the resulting annotated/modified drawing does provide information to the human reader, the information cannot be further processed or analyzed by computerized systems.
Additional known reporting systems permit recorded coded data to be associated with anatomical features depicted on a simple drawing. FIG. 1 through FIG. 4 illustrate versions of a simple drawing and FIG. 5 illustrates an image of the coronary arteries from a known clinical reporting system.
FIG. 1 illustrates a simple drawing of the coronary arteries 10. FIG. 2 illustrates a modified coronary arteries drawing 20, the modifications being based on the recorded coded data 21, Specifically, the modified coronary arteries drawing 20 illustrates the position of a stenotic lesion in the right coronary artery (RCA) symbolized through the insertion of matching thickened lines in the drawing 23 and variations in the branching pattern of the coronary vessels 22. The arrowheads of the lines extending from the number “22” in FIG. 2 show the variations—that is, the portions of the coronary vessels illustrated in the FIG. 1 model drawing 10 that were not found in the patient whose examination was the subject of the recorded coded data 21. FIG. 2 also includes a text label 24 that provides certain of the information from the recorded data 21 regarding that which is shown in the simplified drawing (that is, the amount of stenosis caused by the stenotic lesions in the RCA).
FIG. 3 illustrates a coronary artery drawing 30 producible by a known reporting system that allows a user (e.g., a health care worker) to select a component shown in the drawing—in this example, the Left Anterior Descending Artery, or “LAD”, the selection illustrated in FIG. 3 by the large arrowhead and the partial asterisk shape—, and enter certain data regarding it in a data form 32.
FIG. 4 illustrates another modified coronary arteries drawing 40 producible by a known reporting system that shows extensive modification by a user (such as a health care worker) of the original simple line drawing 10 shown in FIG. 1 in an attempt to more accurately represent the patient's condition. Specifically, modified drawing 40 includes “L” s and thickened dark lines 41 to show coronary lesions, thin vessels marked with “CS” 42 to show collateral circulation, and vessels marked with large “X” s 43 to show that the patient's heart does not have these vessels.
It is clear that, while reporting systems that utilize simple drawings have been widely used, many disadvantages are associated with them. Many such disadvantages, discussed in part above, are produced because the starting point for these systems is a simplified drawing of an anatomy of interest. The health care worker must modify this simplified drawing in an attempt to show what is actually occurring in a patient. The modification process is time consuming and an overall inefficient use of resources and one in which errors in the depictions may arise. The cartoon-like drawings do not present the breadth nor the depth of detail conveyed in the patient's actual medical images nor the physiological/pathological status gathered from such images. The lack of detail may present a challenge to the referring physician to accurately diagnose and treat a patient. While the known illustrated anatomical cartoons may express patient-specific anatomical and pathological variations encountered in medical practice, the result is a very complicated diagram that is very difficult to interpret clinically.
Another known approach illustrated in FIG. 5 permits a user to select a location—or “Region of Interest” 51—on a patient's medical image 50 and enter, for example, a measurement 52 or free text annotation 53. In some known reporting systems, the recorded measurement or free-text annotation may be stored with the medical image. However, these additional components typically remain isolated pieces of information about a particular pixel region on the image. The reporting system does not link the recorded information 52, 53 to the anatomical features and pathologies shown in the image or to the data descriptors associated with these anatomical features and pathologies. Without such linkages, the reporting system is incapable of automatically retrieving or recording clinical data related to the specific anatomical features or pathologies shown in a set of medical images and is incapable of automatically displaying such data at the appropriate locations on the appropriate images for review by a physician—including displaying iconography, drawings, callouts, or notifications derived from such data.
Clearly there is a need for a system and methods by which accurate information regarding the condition of a patient can be recorded and a meaningful report of such condition produced efficiently and with reduced likelihood of errors. The present invention satisfies these demands.